Raleigh photographer Abigail Chopel gave birth to her daughter in January 2020, just at the start of the COVID-19 pandemic.
It was a scary time, she recalled. She couldn’t get her daughter vaccinated until she was 2 years old. Chopel also worried about the health of her grandmother, who was living with them at the time.
“I felt I was at the mercy of my community doing the right thing,” said Chopel, 36, who also has a son who’s now 9 years old.
Now she’s worried that recent changes to federal recommendations for childhood vaccines will lead to more people skipping inoculations against vaccine-preventable illnesses.
The U.S. Centers for Disease Control and Prevention announced on Monday, Jan. 5, that it is reducing the number of diseases covered by recommended childhood vaccines from 17 to 11. Historically, states have used the federal schedule for guidance in crafting their own vaccine recommendations.
North Carolina’s vaccination schedule for children requires two vaccines — against hepatitis B and meningococcal disease — that are no longer recommended by the CDC. North Carolina also recommends hepatitis A vaccination before kindergarten and annual flu shots. The federal government now only recommends those vaccinations for certain children at high risk or based on families having a conversation about risk with a doctor.
NC requirements unchanged
Despite the mismatch between the North Carolina and federal schedules, North Carolina health officials said Wednesday that the state has no plans to change any recommendations about vaccines. Requirements for vaccines that are needed before a child can attend day care and school will not change.
North Carolina’s vaccine schedule aligns with what is recommended by the American Academy of Pediatrics.
Parents can still get all of the originally recommended vaccines for their children, and the shots will still be covered by insurance — at least through 2026, said Raleigh pediatrician Theresa McCarthy Flynn, president of the NC Pediatric Society.
North Carolina health leaders echoed that on Wednesday and encouraged families to stay up to date on vaccinations.
“The scientific evidence around the vaccines has not changed,” Kelly Kimple, director of the state Division of Public Health, told reporters during a virtual news conference. “These vaccines are safe and effective to prevent serious illness and death.”
She said it is normal to have questions.
“I know that these changes are causing confusion,” Kimple said, “and we want to ensure people have clear, reliable information, and know that the vaccines are still available to protect their health.”
Illnesses on the rise
The changes to the federal childhood vaccine recommendations come as vaccination coverage dips and exemptions to vaccination rise nationally and in North Carolina. They also come as the U.S. teeters on the brink of losing its status as having eliminated measles. That status, which the U.S. gained in 2000, is based on not having locally transmitted cases of the same measles strain over a 12-month period.
The country is close to that point, with more than 2,000 measles cases reported in 2025 and new cases already cropping up this year. Last year was marked by several large outbreaks, including 762 cases in west Texas and more than 200 in South Carolina, where 26 new cases have been reported since Friday.
Health officials are investigating whether the outbreaks are connected, which could mean the country no longer qualifies for the measles elimination status. Neighboring Canada recently lost its measles elimination status after a prolonged outbreak that started in 2024, primarily in undervaccinated communities.
North Carolina now has four measles cases connected to the South Carolina outbreak, North Carolina health officials said Wednesday. One case was reported on Dec. 31, 2025, in an unvaccinated child from Polk County.
In the past week, three Buncombe County siblings who had at least one dose of the vaccine have contracted the illness, said Erica Wilson, medical director of the state’s Medical Consultation Unit. She said even though they had received a dose of the vaccine, no vaccine is 100 percent.
There was also an alert of a measles exposure in Gaston County. Another measles case reported in June 2025 involved an international traveler who came through Raleigh-Durham International Airport. The disease is so contagious that a person with measles simply walking past someone who’s unvaccinated can pass on the disease.
Measles is part of a combination vaccine that includes mumps and rubella and is recommended to be taken in two doses — the first dose between 12 and 15 months old and the second between 4 and 6 years old.
“The risk of exposure is growing here in North Carolina,” Kimple warned.
Kimple noted that 93 percent of the 2025 measles cases nationwide were in people who were unvaccinated or whose vaccination status was unknown.
“I think it shows the importance of vaccination to ensure protecting individuals and communities,” she said.
Whooping cough, another vaccine-preventable disease, has also been on an upswing. North Carolina cases topped 800 for the past two years, much higher than the average 411 cases annually before the COVID-19 pandemic, an analysis of state data shows.
What led to the changes?
Revisions to the federal vaccine schedule began last year under a revamped CDC Advisory Committee on Immunization Practices.
The committee was reshaped in June 2025 by Health and Human Services Secretary Robert F. Kennedy Jr., a longtime anti-vaccine activist, who removed all 17 members — including UNC Chapel Hill researcher Noel Brewer — and replaced them with a smaller cadre of members who align with his anti-vaccine views.
Among the changes made since then, the advisory board has dropped recommendations for a universal COVID-19 vaccination every year and for a combined measles, mumps, rubella and varicella (chicken pox) vaccine for children younger than 3. The group also no longer recommends a universal birth dose of the hepatitis B vaccine, which experts said will reverse decades of progress.
“We basically eliminated hepatitis B infections in children less than 10. There was more than a 99 percent decrease,” Paul Offit, director of the Vaccine Education Center at Children’s Hospital of Philadelphia, said during a December webinar to discuss the proposed change before the CDC approved it.
On Dec. 5, President Donald Trump asked federal health leaders to look at how the U.S. childhood vaccine schedule compares with those of peer, developed nations. One of the nations included in the review was the much-smaller Denmark, which has a more seamless health care system with universal health insurance, compared with the fractured system in the U.S. Denmark was also the focus of a presentation last year to the Advisory Committee on Immunization Practices that argued in favor of fewer overall vaccines.
Tracy Beth Høeg, an ex officio member of the committee who made the Denmark presentation, worked with vaccine critic and former ACIP chairman Martin Kulldorff on the assessment the CDC used in its decision to cut back on the number of recommended childhood vaccines.
“The data support a more focused schedule that protects children from the most serious infectious diseases while improving clarity, adherence, and public confidence,” acting CDC Director Jim O’Neill said in a news release.
Chopel doesn’t believe fewer recommendations will have any effect on vaccine hesitancy.
Flynn said the “mixed messaging” has been confusing for families. She fears the outcome will not be good.
“We are going to see more children get very, very sick, and that breaks my heart,” she said.
‘Leaning into people I trust’The CDC revisions to federal vaccine recommendations don’t change any laws, including at the state level, Flynn said.
Kimple told reporters that the change “does not have an immediate impact on the law here in North Carolina.”
However, North Carolina lawmakers have stepped in to change vaccine policy in the state as recently as 2023, when language to prohibit mandated COVID-19 vaccination was included as part of the budget.
Other efforts to change vaccine policy in the state have not been as successful.
Bills filed in the latest General Assembly session have sought to eliminate vaccination requirements for college students, add conscientious objection as an option to be exempt from vaccination mandates, and require three-year approval from the FDA before adding a new childhood vaccine. None of those bills advanced beyond committee meetings.
Earlier legislative efforts to change vaccine requirements in North Carolina also went nowhere.
Typically, any changes to the state’s vaccine schedule would come from the Commission of Public Health, an appointed rulemaking body that looks at immunizations in the interest of public health, according to Kimple.
North Carolina last changed its childhood vaccination schedule in 2015, the state Department of Health and Human Services confirmed in an email to NC Health News. That year, the state added the pneumococcal conjugate and meningococcal vaccines, updated polio language, and added a second dose of varicella (chickenpox) to the schedule.
Health officials encouraged parents to talk to their pediatricians about vaccinations.
“That’s what we’re here for,” Flynn said.
Chopel said that is what she has been doing.
“I’m just really leaning into people I trust,” she said, “and sticking my fingers in my ears and not listening to what the CDC or current administration has to say.”
More information
- Find out about North Carolina’s vaccine requirements for K-12 students.
- Get more information about recommended childhood vaccines.
- How’s your county doing? See state data on the kindergarten immunization dashboard.
- Read about vaccine safety.
- Find out about vaccine-preventable diseases and immunizations in N.C.
- Search an interactive map that connects families with local providers who offer free childhood vaccines through the federal Vaccines for Children program.
Source: N.C. Department of Health and Human Services
This article first appeared on North Carolina Health News and is republished here under a Creative Commons Attribution-NoDerivatives 4.0 International License.
North Carolina Health News is an independent, non-partisan, not-for-profit, statewide news organization dedicated to covering all things health care in North Carolina. Visit NCHN at northcarolinahealthnews.org.
